Advanced practice roles in ophthalmic settings have enabled the delivery of the policy agenda with high quality outcomes. This paper reports on a study undertaken to provide a ‘snapshot’ of such roles. It was found that while roles are diverse and continue to respond to service need, ophthalmologists, rather than nurses, control many of the parameters of the role and undertake much of the training and assessment. All nurses in this study undertook in-house training rather than education for their roles and none was able to be supernumerary which, in some cases, delayed service development. It is suggested that nursing administration must recognise the need for education as well as training and advocate for it in order that roles may be developed effectively and systematically. Copyright © 2006 John Wiley & Sons, Ltd.